SYSTEMIC LUPUS

ERYTHEMATOSUS (SLE)

:Presented by
Dr. Walaa mousa

Multisystem inflammatory
autoimmune disease
with a broad spectrum of clinical
manifestations
in association with antinuclear
antibody (ANA) production

Epidemiology
Prevalence 1550/100,000;
predominantly affects women 2nd to
4th decade
F:M ratio= 8:1;
African American:Caucasian ratio=
4:1
Complex genetics;
some HLA assoc.;
rare C1q & C2 defic.

Workup
Autoantibodies: ANA, if + anti-ds-DNA, anti-Sm,
anti-Ro, anti-La, anti-U1-RNP

Lytes, BUN, Cr, U/A, urine sed, spot microalb:Cr ratio

or 24-h urine for CrCl and
protein

CBC, PTT, APLA ( + in 2040%; ACL IgG/IgM, B2GP1,

lupus anticoagulant), C3, C4

If GFR, active sediment, hematuria or proteinuria

renal bx to guide Rx

Prognosis
5-y survival rate > 90%, 10-y survival
rate > 80%
Leading causes of morbidity and
mortality:

infection,
renal failure,
neurologic and
cardiovascular events; thrombotic
complications

Drug-induced lupus
(DLE)

Many drugs:
procainamide, hydralazine, penicillamine,
minocycline, INH,methyldopa, quinidine,
chlorpromazine, diltiazem, anti-TNF (esp. infliximab),
interferons
Idiosyncratic onset;
generally mild disease with arthritis, serositis, skin disease

+ Anti-histone (95%) (may be - in anti-TNF); - anti-dsDNA (may be + in anti-TNF)

& anti-Sm; normal complement levels
Usually reversible w/in 46 wk after stopping
medication